{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:58:31Z","timestamp":1792205911280,"version":"4.4.0"},"reference-count":16,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Free\u2010flap reconstruction of head\u2010and\u2010neck defects is often complicated by a vessel\u2010depleted neck after prior surgery or radiotherapy. Conventional alternatives\u2014such as using contralateral vessels, distant recipient vessels, or interpositional vein grafts\u2014are technically demanding and associated with additional risks. We present two salvage reconstructions in which the vascular pedicle of a previously transferred free flap was reused as recipient vessels when standard options were unavailable. A 79\u2010year\u2010old man developed exposure of a titanium mandibular plate 6\u2009years after mandibular resection reconstructed with a free anterolateral thigh (ALT) flap. Preoperative ultrasonography and contrast\u2010enhanced computed tomography confirmed patency of the ALT flap pedicle despite dense fibrosis. After removal of the exposed plate, the pedicle was carefully dissected, and a scapular osteocutaneous flap (9\u2009\u00d7\u200912\u2009cm skin, 2.5\u2009\u00d7\u200911\u2009cm bone) was anastomosed to the lateral circumflex femoral artery and vein of the existing pedicle. Both flaps survived, and postoperative cholecystitis was managed conservatively. In another case, a 63\u2010year\u2010old man with a history of reconstruction using a free ALT flap for recurrent temporal meningioma developed another recurrence 2\u2009years later. Imaging confirmed patency of the previous pedicle. During salvage surgery, the pedicle was dissected, and a free rectus\u2010abdominis flap (9\u2009\u00d7\u200920\u2009cm) was harvested. Arterial anastomosis was performed to the artery of the previous ALT pedicle, and venous drainage was established directly into the internal jugular vein due to insufficient pedicle vein caliber. Intraoperative indocyanine green fluorescence angiography confirmed flap perfusion, and both flaps healed uneventfully. These cases show that reusing the vascular pedicle of a prior free flap may provide a practical salvage option in vessel\u2010depleted necks. Careful preoperative imaging, intraoperative assessment of flap viability, and meticulous microsurgical technique are essential for success. This approach suggests that pedicle reuse may simplify salvage reconstruction while preserving previously transferred flaps when conventional recipient vessels are unavailable.<\/jats:p>","DOI":"10.1002\/micr.70141","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T13:16:21Z","timestamp":1762348581000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Salvage Reconstruction With Recycled Flap Pedicles in Head\u2010and\u2010Neck Surgery: A Report of Two Cases"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2497-3072","authenticated-orcid":false,"given":"Akatsuki","family":"Kondo","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Umezawa","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Taga","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rei","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25853"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.PRS.0000119872.60605.90"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198408000-00018"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.12888"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-021-09590-y"},{"key":"e_1_2_8_7_1","article-title":"Neovascularization Failure of an Interposed Free Intestinal Colon Flap 10\u2009Years After Esophageal Reconstruction","volume":"2","author":"Manrique O. J.","year":"2017","journal-title":"Journal of Reconstructive Microsurgery Open"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-196905000-00001"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199309001-00011"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1006951"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.5999\/aps.2018.00171"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/02844310310007872"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1006632"},{"key":"e_1_2_8_14_1","first-page":"55","article-title":"Utility of the Combined Use of an Anterolateral Thigh Flap and the Vastus Lateralis Muscle for Reconstructing Multi\u2010Recurrent Skull Base Tumor\u2010Induced Defects","volume":"32","author":"Sakurai T.","year":"2016","journal-title":"Journal of the Japanese Society of Craniomaxillofacial Surgery"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22270"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/8564922"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30082"}],"container-title":["Microsurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.70141","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/micr.70141","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/micr.70141","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T09:07:01Z","timestamp":1773133621000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/micr.70141"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,5]]},"references-count":16,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/micr.70141"],"URL":"https:\/\/doi.org\/10.1002\/micr.70141","archive":["Portico"],"relation":{},"ISSN":["0738-1085","1098-2752"],"issn-type":[{"value":"0738-1085","type":"print"},{"value":"1098-2752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,5]]},"assertion":[{"value":"2025-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70141"}}